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1.
Rev. cuba. med ; 60(1): e1399, tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1156554

RESUMO

RESUMEN Introducción: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina es una técnica novedosa para el diagnóstico de tumores y ganglios mediastínicos e hiliares. Objetivo: Evaluar la eficacia diagnóstica de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina como método de estudio de lesiones hiliares y mediastinales. Métodos: Se realizó un estudio descriptivo con carácter prospectivo en 49 pacientes a los que se le realizó ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina. Resultados: El diagnóstico se obtuvo mediante la histología y resultaron positivos 48 pacientes, de ellos 45 fueron positivos por el ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina y 4 negativos por este estudio. El resultado global de la investigación mostró una sensibilidad de 93,8 %, especificidad 100 %, valor predictivo positivo de 100 % y predictivo negativo 25 %. De esta manera, el índice de validez de ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina fue de 93,8 %. El número de complicaciones fue mínimo. Conclusiones: El ultrasonido endobronquial lineal con aspiración transbronquial por aguja fina constituye un método diagnóstico eficaz y seguro en el estudio de pacientes que presentan lesiones hiliares y mediastinales con alta sospecha de cáncer de pulmón y a su vez, una alternativa de acceder al mediastino de manera no cruenta para la estadificación ganglionar.


ABSTRACT Introduction: Linear endobronchial ultrasound with transbronchial fine needle aspiration is a novel technique for the diagnosis of tumors and mediastinal and hilar lymph nodes. Objective: To evaluate the diagnostic efficacy of linear endobronchial ultrasound with transbronchial fine needle aspiration as a method of studying hila and mediastinal lesions. Methods: A prospective descriptive study was carried out in 49 patients who underwent linear endobronchial ultrasound with transbronchial fine needle aspiration. Results: The diagnosis was obtained by histology and 48 patients were positive, 45 of them resulted positive by linear endobronchial ultrasound with transbronchial fine needle aspiration and 4 resulted negative by this study. The overall result of the investigation showed a sensitivity of 93.8%, specificity 100%, a positive predictive value of 100% and a negative predictive value of 25%. Thus, the validity index of linear endobronchial ultrasound with transbronchial fine needle aspiration was 93.8%. The number of complications was minimal. Conclusions: Linear endobronchial ultrasound with transbronchial fine needle aspiration is an effective and safe diagnostic method in the study of patients with hilar and mediastinal lesions with high suspicion of lung cancer and, consecutively, it is an alternative to access the mediastinum in a non- invasive approach for lymph node staging.


Assuntos
Humanos , Masculino , Feminino , Ultrassom/métodos , Broncoscopia/métodos , Biópsia por Agulha Fina/métodos , Epidemiologia Descritiva , Estudos Prospectivos
3.
Am J Otolaryngol ; 42(1): 102590, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33045535

RESUMO

PURPOSE: Major salivary gland tumors constitute almost 3% of head and neck tumors. Tumors located exclusively in the deep lobe are not common and 20% of parotid gland tumors originate from deep lobe under the branches of the facial nerve. Accuracy of fine needle aspiration biopsy (FNAB) procedure in salivary gland tumors have been studied extensively, however there isn't any data regarding usefulness of FNAB in tumors located exclusively in deep lobe of parotid gland. In this study we aimed to assess the use of FNAB in deep lobe parotid tumors. MATERIALS AND METHODS: We retrospectively analyzed 51 patients with deep lobe parotid tumors who underwent surgery in our clinic between January 2013-December 2018. Characteristics of patients were recorded. Preoperative FNAB results and postoperative final histopathologic diagnosis were compared. Statistical analysis was performed using SPSS 24.0 was used for statistical analysis. RESULTS: The number of patients that met the inclusion criteria was 51. The mean age of patients were 49.2(14-86). In 40 (78.4) of the patients, tumor was reported as benign and in 11 (21.6) patients FNAB diagnosis was suspicious for malignancy, malignant or non-diagnostic. In final histopathologic diagnosis, 42 of the tumors were benign and 9 were malignant. The most common benign tumor type was pleomorphic adenoma which constitutes 27 of the cases (52.9%). Regarding detection of malignant disease, the sensitivity of FNAB was 90.4%, specificity was 77.7%, positive predictive value was 95%, negative predictive value was 63.6%. There was a substantial agreement between FNAB and final histopathologic diagnosis(kappa = 0,628). CONCLUSIONS: FNAB is a safe and reliable tool to evaluate deep lobe parotid tumors. It is an important part of preoperative surgical planning and can help the surgeon in patient counseling. FNAB with ultrasound guidance is recommended for deep lobe tumors.


Assuntos
Biópsia por Agulha Fina/métodos , Citodiagnóstico/métodos , Biópsia Guiada por Imagem/métodos , Glândula Parótida/patologia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/cirurgia , Adenoma Pleomorfo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Parotídeas/diagnóstico , Período Pós-Operatório , Período Pré-Operatório , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
4.
Acta otorrinolaringol. esp ; 71(6): 343-348, nov.-dic. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-198077

RESUMO

BACKGROUND: Fine needle aspiration cytology (FNAC) is an established technique in the management of salivary gland lesions. The Milan System for reporting salivary gland cytopathology (MSRSGC) intents to standardize diagnostic categories. Current studies are trying to evaluate the diagnostic approach of this system. METHODS: FNAC of salivary gland lesions were retrieved over an 11-year period. 185 FNAC specimens from 182 patients were reviewed blindly and classified according to the criteria established by the MSRSGC. 136 (74.7%) patients had follow-up of their processes. RESULTS: The total number of diagnostic categories and risk of malignancy (ROM) in 185 specimens were the following: non-diagnostic 39 (21.1%; ROM 12%), non-neoplastic 35 (18.9%; ROM 0%), atypia of undetermined significance (AUS) 17 (9.2%; ROM 46.1%), benign neoplasm 75 (40.5%; ROM 4.9%), salivary gland neoplasm of uncertain malignant potential 4 (2.2%; ROM 100%), suspicious for malignancy 7 (3.8%; ROM 100%), malignant 8 (4.3%; ROM 100%). No false positives were observed in groups IVb, V, and VI in this series. The overall sensitivity, specificity, negative predictive value, positive predictive value and diagnostic accuracy were 88%, 91.8%, 96.3%, 76.7%, and 91% respectively. CONCLUSION: The ROM reported in our study was in keeping with ROM published by the MSRSGC. This system provides standardized information for risk stratification. The category AUS encompassed cases causing uncertainty representing a challenge in management. Defining criteria for AUS category need to be refined. The system facilitates communication between pathologists and clinicians favoring improvement in patient care


ANTECEDENTES: La citología por punción-aspiración con aguja fina (PAAF) está establecida en el tratamiento de las lesiones de las glándulas salivales. El sistema Milán (SM) intenta homogeneizar las categorías diagnósticas en los informes citológicos. Los estudios actuales están tratando de evaluar el enfoque diagnóstico de este sistema. MÉTODOS: Se revisaron las PAAF de las glándulas salivales obtenidas durante un período de 11 años. Se revisaron a ciegas 185 muestras de PAAF de 182 pacientes, y se clasificaron de acuerdo con los criterios establecidos por el SM. Se realizó seguimiento de los procesos de 136 (74,7%) pacientes. RESULTADOS: Los totales de categorías diagnósticas y el riesgo de malignidad (ROM) en 185 muestras fueron los siguientes: no diagnóstico 39 (21,1%; ROM 12%), no neoplásico 35 (18,9%; ROM 0%), atipia de significación indeterminada (ASI) 17 (9,2%; ROM 46,1%), neoplasia benigna 75 (40,5%; ROM 4.9%), neoplasia de potencial maligno incierto 4 (2,2%; ROM 100%), sospecha de malignidad 7 (3,8%; ROM 100%), malignidad 8 (4,3%; ROM 100%). No se observaron falsos positivos en los grupos IVb, V y VI. Los valores de sensibilidad, especificidad, el valor predictivo negativo, el valor predictivo positivo y la precisión diagnóstica fueron del 88%, 91,8%, 96,3%, 76,7% y 91%, respectivamente. CONCLUSIÓN: El ROM observado concordaba con el ROM publicado por el SM. Este proporciona información estandarizada para la estratificación del riesgo. La categoría ASI abarcó los casos que causaron incertidumbre, y representa un desafío en el manejo de los pacientes. Los criterios de definición de ASI deberían perfeccionarse. El sistema facilita la comunicación entre patólogos y clínicos, y mejora la atención al paciente


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/patologia , Biópsia por Agulha Fina/métodos , Estudos Retrospectivos , Glândulas Salivares/patologia , Medição de Risco/métodos , Valor Preditivo dos Testes , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/patologia
5.
Medicine (Baltimore) ; 99(51): e23846, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371167

RESUMO

ABSTRACT: Spontaneous intranodular hemorrhaging in benign partially cystic thyroid nodules was reported to cause neck swelling, difficulty swallowing, and other oppressive symptoms attributed to their growing progressively at high rates. In our study, the risk factors for hemorrhaging in these nodules were investigated.We retrospectively analyzed benign partial cystic thyroid nodules from September 2017 to December 2019, and divided them into 2 groups according to the occurrence of intranodular hemorrhage. Age, gender, follow-up time nodules initial maximum diameter, blood supply, spongiform content, nodules solid components, and internal solid portion were compared between the 2 groups at the first ultrasound examination. Chi-Squared and multivariate analysis were performed to evaluate the association of hemorrhage with clinical and ultrasonographic characteristics. ROC analysis was performed to evaluate the utility of factors in predicting hemorrhage.There were 59 occurrences of intranodular hemorrhage, which were associated with abundant blood supply, spongiform contents, and unsmooth margin of the internal solid portion. After multivariate analysis, abundant blood supply, and spongiform content were independent predictors for hemorrhage. In ROC analysis integrating these predictors, the sensitivity was 62.7% and specificity was 95.2% with the AUC 0.881.Partially cystic thyroid nodules with abundant blood supply, non-smooth margin of the internal solid portion and a spongiform internal content were apt to spontaneous intranodular hemorrhaging, which can be recognized as soon as possible by ultrasound.


Assuntos
Hemorragia/etiologia , Neoplasias da Glândula Tireoide/complicações , Nódulo da Glândula Tireoide/complicações , Adulto , Biópsia por Agulha Fina/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/fisiopatologia , Nódulo da Glândula Tireoide/fisiopatologia , Ultrassonografia/métodos
6.
Radiol Clin North Am ; 58(6): 1041-1057, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040847

RESUMO

Thyroid ultrasound with gray-scale and color Doppler is the most helpful imaging modality to differentiate normal thyroid parenchyma from diffuse or nodular thyroid disease by evaluating glandular size, echogenicity, echotexture, margins, and vascularity. The various causes of diffuse thyroid disease often have overlapping sonographic imaging features. Thyroid nodules may be hyperplastic or neoplastic, with most due to benign hyperplastic changes in architecture and benign follicular adenomas; only a small percentage are malignant. A systematic approach to nodule morphology that includes evaluation of composition, echogenicity, margin, shape, and any echogenic foci can guide decision to biopsy or follow nodules.


Assuntos
Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Biópsia por Agulha Fina/métodos , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Medição de Risco , Doenças da Glândula Tireoide/diagnóstico por imagem , Doenças da Glândula Tireoide/patologia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler em Cores/métodos
7.
Radiol Clin North Am ; 58(6): 1085-1098, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33040850

RESUMO

Fine-needle aspiration (FNA) and core biopsy of masses in the neck predominantly include samples from thyroid nodules, parathyroids and lymph nodes. The diagnostic rate of a thyroid nodule FNA improves up to 6 passes and then does not significantly change. Thyroid FNA can be performed on patients who are anticoagulated. Appropriate transducer selection is essential for visualization of the needle. Lymph node biopsies can be additionally sampled for thyroglobulin assay to improve sensitivity for detection of recurrent carcinoma. Parathyroid FNA usually involves additional estimation of parathyroid hormone concentration in needle washouts. Biopsies of the neck are simple procedures with minimal complications.


Assuntos
Biópsia por Agulha Fina/métodos , Biópsia com Agulha de Grande Calibre/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias das Paratireoides/patologia , Neoplasias da Glândula Tireoide/patologia , Feminino , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Neoplasias das Paratireoides/diagnóstico por imagem , Melhoria de Qualidade , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler/métodos
8.
Medicine (Baltimore) ; 99(40): e22458, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019434

RESUMO

RATIONALE: Endo-bronchial ultrasound guided trans-bronchial needle aspiration (EBUS-TBNA) has been widely accepted as a safe and efficient technique for diagnosing patients with mediastinal/hilar lymphadenopathy and suspected cases of lung cancer. An effective anesthetic technique should provide comfort and quick recovery of patients while allowing the clinicians to obtain adequate tissue sample. Therefore we combined mask ventilation support (SIMV), BIS monitoring, and short-acting medication to achieve the effect mentioned above. PATIENT CONCERNS: In this report, both patients had lung mass accompanied by cough that lasted for >2 weeks, and were admitted to hospital for further diagnosis and treatment to clarify the nature of the mass. To make a definite diagnosis, EBUS-TBNA examination was performed under general anesthesia. Both patients had no salient past history. DIAGNOSIS: Case 1 was diagnosed as tumor or pneumonia based on the right lung shadow. Case 2 was diagnosed with squamous cell carcinoma of the right lung with right hilar lymph node metastasis. The diagnostic results of both patients were based on pathological examination of tissues obtained by EBUS-TBNA, of which case 1 required further confirmation by lung biopsy. INTERVENTION: Both the patients received antibiotic treatment before EBUS-TBNA. We used the mask ventilation supported by SIMV mode without using muscle relaxant, thus providing a guarantee for rapid and high-quality recovery of patients. OUTCOMES: During EBUS-TBNA, the vital signs of the 2 patients were stable. Both patients recovered within 5 minutes after we stopped pumping general anesthetics. None of the patient complained of any discomfort and felt comfortable. No complications occurred during and 3 months after EBUS-TBNA examination. LESSONS: The obtained results showed that this anesthesia scheme can provide appropriate depth of anesthesia for patients undergoing EBUS-TBNA examination, while ensuring rapid and high-quality recovery of patients.


Assuntos
Anestesia Geral/métodos , Biópsia por Agulha Fina/métodos , Biópsia Guiada por Imagem , Administração Intravenosa , Feminino , Humanos , Intubação Intratraqueal/efeitos adversos , Máscaras Laríngeas , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade
11.
Medicine (Baltimore) ; 99(28): e20829, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664077

RESUMO

INTRODUCTION: Anabolic steroids are widely administered to patients with aplastic anemia (AA) and are associated with numerous medical complications. To assist with future diagnoses, we report about a young boy with multiple hepatocellular adenomas (HAs) induced by long-term use of anabolic androgenic steroids (AAS) for AA and present a related literature review. PATIENT CONCERN: A 15-year-old boy who was diagnosed with AA in 2011 had been treated with stanozolol (6 mg per day) and ciclosporin A (120-150 mg per day) for almost 4 years. He presented with epigastric pain and fever, and abdominal computed tomography showed a lesion of heterogenous density measuring 13.5 × 13.0 × 8.0 cm in the left hepatic lobe, which was initially misdiagnosed as a liver abscess. DIAGNOSIS: The patient went into hemorrhagic shock twice after invasive manipulation that aimed at diagnosis and was finally diagnosed with HA using fine needle aspiration. INTERVENTIONS: The patient discontinued AAS and only reserved ciclosporin A for AA treatment. OUTCOMES: Follow-up abdominal computed tomography performed 4 years after AAS discontinuation showed obvious regression of the hepatic lesions. CONCLUSION: It is of great importance for hematologists to completely understand that the long-term use of AAS may cause HA, which carries a great risk of hemorrhage and malignant transformation.


Assuntos
Adenoma de Células Hepáticas/induzido quimicamente , Anemia Aplástica/complicações , Neoplasias Hepáticas/patologia , Estanozolol/efeitos adversos , Congêneres da Testosterona/efeitos adversos , Dor Abdominal/etiologia , Adenoma de Células Hepáticas/patologia , Adolescente , Adulto , Assistência ao Convalescente , Idoso , Anemia Aplástica/tratamento farmacológico , Biópsia por Agulha Fina/métodos , Ciclosporina/uso terapêutico , Erros de Diagnóstico , Feminino , Febre/etiologia , Humanos , Imunossupressores/uso terapêutico , Abscesso Hepático/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Choque Hemorrágico/diagnóstico , Choque Hemorrágico/etiologia , Estanozolol/uso terapêutico , Congêneres da Testosterona/uso terapêutico , Tomografia Computadorizada por Raios X/métodos
12.
BMC Infect Dis ; 20(1): 516, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677915

RESUMO

BACKGROUND: The role of ultrasonography-guided percutaneous fine-needle aspiration (PNA) for pyogenic liver abscess (PLA) remains without consensus, especially in abscesses 3 to 6 cm in diameter. The objective of this study was to evaluate the comparative effectiveness and safety of PNA combined with antibiotics. METHODS: This was a retrospective study of patients with PLA that were from 3 to 6 cm in diameter who treated at two medical centers in Shanghai, China, from January 2014 to March 2019. Patients were divided into groups treated by PNA plus antibiotics or antibiotics alone. Patients demographics and clinical data related diagnosis, antibiotic treatment, and patient outcomes were analyzed. RESULTS: Out of a total of 94 PLA patients, 42 (44.7%) patients received PNA combined with antibiotics, and 52 (55.3%) received antibiotics alone. There were no complications related to PNA. In the PNA group, 13 (31.7%) patients with negative blood culture and 8 (19.5%) patients without blood culture were microbiologically confirmed via aspiration. The time for temperature normalization (P < 0.001) and the reduction rate of C-reactive protein within the first week (P = 0.031) were significantly lower in the PNA group. In the multivariate analysis, treatment with PNA was more likely to result in clinical improvement of PLA (odds ratio = 0.33, 95% confidence intervals (CI): 0.11-0.96, P = 0.043). CONCLUSIONS: PNA combined with antibiotics appears to be a safe, effective, and promising treatment for PLA of 3-6 cm in size. Furthermore, the technique allows for direct microbial sample, which can improve the selection of antibiotics.


Assuntos
Drenagem/métodos , Abscesso Hepático Piogênico/diagnóstico , Abscesso Hepático Piogênico/terapia , Ultrassonografia de Intervenção/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Biópsia por Agulha Fina/efeitos adversos , Biópsia por Agulha Fina/métodos , China , Terapia Combinada , Drenagem/efeitos adversos , Feminino , Humanos , Abscesso Hepático Piogênico/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ultrassonografia de Intervenção/efeitos adversos
13.
Acta Cytol ; 64(6): 532-538, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702707

RESUMO

OBJECTIVE: The aim of the study was to study the clinical and morphological spectrum of histoplasmosis diagnosed by fine needle aspiration cytology (FNAC). STUDY DESIGN: A total of 17 patients diagnosed with histoplasmosis on FNAC were studied over a period of 5 years. The cytology smears were studied and analysed for the cytomorphological spectrum of histoplasmosis. RESULTS: Among the 17 patients studied, the mean age was 51.3 years (range 6-84 years). Male-to-female ratio was 3.25:1 with 4 females and 13 males. The frequent sites of involvement were the lung (5), lymph node (4), adrenal gland (4), and skin (4). The most common cytological patterns were histiocytic collection, followed by granulomas and multinucleated giant cells. Necrosis was noted in only 4 cases. CONCLUSION: Fine needle aspiration is a highly accurate, rapid, and cheap technique for the diagnosis of histoplasmosis due to its distinct morphological features.


Assuntos
Células Gigantes/patologia , Granuloma/patologia , Histoplasmose/patologia , Linfonodos/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina/métodos , Criança , Citodiagnóstico/métodos , Diagnóstico Diferencial , Feminino , Granuloma/diagnóstico , Histoplasmose/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
Clinics (Sao Paulo) ; 75: e1594, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32578823

RESUMO

OBJECTIVE: Fine-needle aspiration cytology is the risk stratification tool for thyroid nodules, and ultrasound elastography is not routinely used for the differential diagnosis of thyroid cancer. The current study aimed to compare the diagnostic parameters of ultrasound elastography and fine-needle aspiration cytology, using surgical pathology as the reference standard. METHODS: In total, 205 patients with abnormal thyroid function test results underwent ultrasound-guided fine-needle aspiration cytology on the basis of the American College of Radiology Thyroid Imaging-Reporting and Data System classification and strain ultrasound elastography according to the ASTERIA criteria. Histopathological examination of the surgical specimens was performed according to the 2017 World Health Organization classification system. Moreover, a beneficial score analysis for each modality was conducted. RESULTS: Of 265 nodules, 212 measured ≥1 cm. The strain index value increased from benign to malignant nodules, and the presence of autoimmune thyroid diseases did not affect the results (p>0.05 for all categories). The sensitivities of histopathological examination, ultrasound elastography, and fine-needle aspiration cytology for detection of nodules measuring ≥1 cm were 1, 1, and 0.97, respectively. The working area for detecting nodule(s) in a single image was similar between strain ultrasound elastography and fine-needle aspiration cytology for highly and moderately suspicious nodules. However, for mildly suspicious, unsuspicious, and benign nodules, the working area for detecting nodule(s) in a single image was higher in strain ultrasound elastography than in fine-needle aspiration cytology. CONCLUSION: Strain ultrasound elastography for highly and moderately suspicious nodules facilitated the detection of mildly suspicious, unsuspicious, and benign nodules.


Assuntos
Biópsia por Agulha Fina/métodos , Técnicas de Imagem por Elasticidade/métodos , Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Tireotropina/sangue
16.
Acta Cytol ; 64(6): 520-531, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32526741

RESUMO

BACKGROUND: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY: This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.


Assuntos
Biópsia por Agulha Fina , Carcinoma Mucoepidermoide/patologia , Segunda Neoplasia Primária/patologia , Neoplasias das Glândulas Salivares/patologia , Adenoma Pleomorfo/patologia , Adolescente , Biópsia por Agulha Fina/métodos , Criança , Feminino , Humanos , Masculino , Neoplasias Parotídeas/patologia , Glândulas Salivares/patologia
17.
Acta Cytol ; 64(6): 612-616, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32526747

RESUMO

BACKGROUND: Metastases to axillary lymph nodes are commonly and readily confirmed by fine needle aspiration cytology (FNAC). Most likely, these arise from breast primaries. However, the diagnosis can become complicated when unusual cytomorphology is encountered. CASE: We report a 60-year-old woman presenting with bilateral axillary lymphadenopathies but without breast lesions. History showed increasing CA-125 levels. FNAC yielded carcinoma cells showing prominent papillary pattern, being composed of mild to moderately differentiated malignant cells, with focal abortive glandular formation and squamous metaplasia. IHC stains were done and the tumor cells were PAX-8 positive, but GATA-3 and GCDFP-15 negative. Coupled with the clinical history, a diagnosis of metastatic endometrioid adenocarcinoma was made. CONCLUSION: Nodal metastases with papillary cytomorphology can rarely arise from nonbreast primaries. The presence of papillary pattern, particularly in the absence of a clinically detectable breast lesion, should raise the possibility of a metastasis. Correlation with patient history, imaging findings and judicious use of IHC studies are crucial for a correct diagnosis.


Assuntos
Axila/patologia , Neoplasias da Mama/patologia , Linfonodos/patologia , Metástase Linfática/patologia , Biópsia por Agulha Fina/métodos , Mama/patologia , Neoplasias da Mama/diagnóstico , Feminino , Humanos , Metástase Linfática/diagnóstico , Pessoa de Meia-Idade , Ultrassonografia de Intervenção/métodos
18.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 47(2): 69-71, abr.-jun. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193713

RESUMO

La mastopatía diabética es una entidad infrecuente. La presentación más común suele ser en forma de nódulo único o múltiple. Sus características clínicas y radiológicas pueden simular un cáncer de mama, por lo que debe tenerse en cuenta este diagnóstico diferencial en las pacientes jóvenes y con antecedentes de diabetes mellitus. Un correcto diagnóstico puede evitar tratamientos quirúrgicos innecesarios. Presentamos 2 casos que hemos diagnosticado en nuestra área sanitaria así como la revisión de la bibliografía al respecto


Diabetic mastopathy is an uncommon disorder, in which the most frequent presentation is as a single or multiple nodules. It can imitate breast cancer both clinically and radiologically. A differential diagnosis should be done in young patients with a personal history of diabetes, in order to avoid unnecessary surgical interventions. Two cases are presented that were diagnosed in our health area, as well as a review of the literature on this pathology


Assuntos
Humanos , Feminino , Adulto , Adulto Jovem , Doença da Mama Fibrocística/diagnóstico por imagem , Doença da Mama Fibrocística/cirurgia , Doença da Mama Fibrocística/complicações , Diagnóstico Diferencial , Fibroadenoma/complicações , Mama/diagnóstico por imagem , Mama/patologia , Biópsia por Agulha Fina/métodos , Diabetes Mellitus/diagnóstico
19.
Aust J Gen Pract ; 49(5): 267-271, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32416659

RESUMO

BACKGROUND: Neck masses in adults are a common presentation for head and neck cancer. Head and neck cancer accounts for 3.4% of all malignancies in Australia, and the incidence of oropharyngeal squamous cell carcinoma is rising. Early diagnosis is essential to prevent worsening prognosis. OBJECTIVE: This article provides a brief overview of neck masses in adults, with a guideline to work-up and management in a primary care setting. DISCUSSION: All neck masses should be considered malignant until proven otherwise. Detailed history and examination is crucial in the initial work-up. Fine-needle aspiration and computed tomography of the neck with contrast make up the mainstay of first-line investigation.


Assuntos
Neoplasias de Cabeça e Pescoço/diagnóstico , Pescoço/anormalidades , Pescoço/diagnóstico por imagem , Prognóstico , Adulto , Austrália/epidemiologia , Biópsia por Agulha Fina/métodos , Meios de Contraste/uso terapêutico , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Pescoço/fisiopatologia , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/psicologia , Tomografia Computadorizada por Raios X/métodos
20.
Acta Cytol ; 64(4): 306-322, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32454496

RESUMO

BACKGROUND: The evaluation of lymph nodes (LN) by fine-needle aspiration cytology (FNAC) is routinely used in many institutions but it is not uniformly accepted mainly because of the lack of guidelines and a cytopathological diagnostic classification. A committee of cytopathologists has developed a system of performance, classification, and reporting for LN-FNAC. METHODS: The committee members prepared a document that has circulated among them five times; the final text has been approved by all the participants. It is based on a review of the international literature and on the expertise of the members. The system integrates clinical and imaging data with cytopathological features and ancillary techniques. The project has received the endorsement and patronage of the International Academy of Cytology and the European Federation of the Cytology Societies. RESULTS: Clinical, imaging, and serological data of lymphadenopathies, indications for LN-FNAC, technical procedures, and ancillary techniques are evaluated with specific recommendations. The reporting system includes two diagnostic levels. The first should provide basic diagnostic information and includes five categories: inadequate/insufficient, benign, atypical lymphoid cells of undetermined/uncertain significance, suspicious, and malignant. For each category, specific recommendations are provided. The second diagnostic level, when achievable, should produce the identification of specific benign or malignant entities and additional information by utilizing ancillary testing. CONCLUSION: The authors believe that the introduction of this system for performing and reporting LN-FNAC may improve the quality of the procedure, the report, and the communication between cytopathologists and the clinicians. This system may lead to a greater acceptance and utilization of LN-FNAC and to a better interdisciplinary understanding of the results of this procedure.


Assuntos
Biópsia por Agulha Fina/métodos , Citodiagnóstico/métodos , Linfonodos/patologia , Humanos
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